TIA/ transient ischaemic attack

Question 1

Risk factors for TIA

Answer 1

Lifestyle:
-smoking, alcohol, drugs, diet, lack exercise
Cardiovascular diseases
-hypertension
-AF
-valvular disease
-CAD
-congestive heart failure
-congenital heart disease
Other factors
-age(55+), gender (younger men), hyperlipidaemia, diabetes, sickle cell disease, hypercoagulable diseases, chronic kidney disease

Question 2

TIA-

Answer 2

-transient episode of neurologic dysfunction due to focal brain, spinal cord or retinal ischaemia without acute infarction or tissue injury

Question 3

TIA pathophysiology

Answer 3

-brief blockage of bloodflow to the brain can be due to atherosclerosis, cardiac embolism, hypercoaguability
-prevents brain tissue getting nutrients and removing waste
-can lead to tissue damage in minutes

Question 4

TIA signs and symptoms

Answer 4

-confusion, reduced LOC
-headache- sudden and severe
-weakness- face, limbs
-sensory loss- paraesthesia or numbness
-speech problems
-visual problems
-dizziness/ vertigo
-nausea/ vomiting
-loss of coordination
-specific cranial nerve deficits

Question 5

TIA assessment

Answer 5

-FAST test
-if positive convey to hospital
-if negative do MEND exam
-then ABCD2 score if we think its fully resolved (no current symptoms)
ABCD2 score (has been de-emphasized)
-measures likelihood of having full blown stroke
-based off what is reported from family or patient

Question 6

TIA treatment and management

Answer 6

Convey following to ED
-crescendo TIA (more than 1 in 7 days)
-prescribed anticoagulants
-diagnosed clotting disorders
-diagnosis AF or AF on ECG
-ABCD2 of more than 4

-if not meeting high risk criteria, refer to TIA clinic for appointment within 24hrs
-consider supplying aspirin if all symptoms resolved (ONLY if TIA, NEVER GIVE ASPIRIN FOR STROKES AS CAN MAKE HAEMORRHAGIC WORSE)